Provider Demographics
NPI:1407956683
Name:ROSE DEVERA-HIPOL MD & MANUEL A HIPOL MD PC
Entity Type:Organization
Organization Name:ROSE DEVERA-HIPOL MD & MANUEL A HIPOL MD PC
Other - Org Name:HIPOL CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MD
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:DEVERA
Authorized Official - Last Name:HIPOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-499-6395
Mailing Address - Street 1:701 INDEPENDENCE CIRCLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-499-6395
Mailing Address - Fax:757-499-8026
Practice Address - Street 1:701 INDEPENDENCE CIRCLE
Practice Address - Street 2:SUITE 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455
Practice Address - Country:US
Practice Address - Phone:757-499-6395
Practice Address - Fax:757-499-8026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty